VOX article on physicians doing expensive procedures

[DrCommonSense]

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Why American doctors keep doing expensive procedures that don’t work

This appears to be the reason that NEJM wrote an article about avoiding the "rationing" of care by a cardiologist due to the bad press about STENTS.

Is rationing of care the best policy going forward or are there better ways for cost reduction?

Or should we just negotiate drug prices better, cut administrative overhead, have less end of life care and bring procedures into lower cost centers (outside of hospitals) to obtain sufficient savings to avoid any rationing of care?

 

[Biohazard685]

I have mixed feelings, mostly rage, but some are legitimate and I'm sure typing this rant on mobile will make me look even more foolish.

This article was written by someone who is not in the field and I instantly get fired up when I notice the authors background.

The title is very generalizing and is set up like modern day clickbait.

The entire article tries to endorse a one size fits all mentality for medicine.

They start with stents for non emergent chest pain and then keep talking as if the most important use of stents is for non emergent chest pain and used a study that self admits that the results need more analysis.

They mention multiple procedures (arthroscopy, lumbar fusion) and only a handful of negative studies. Ok, so where are the positive studies? Where is the comparison and analysis of results? None of that stuff is sexy material for clickbait and sensationalism.

This kind of fear mongering may lead to a situation where your average Joe eschews standard of care because of some sensationalist article (see Anti-Vax movement).

 

[HmmPie]

Not sure if anyone is reading this thread, but I agree partly with Biohazard, in terms of having a similar visceral reaction. The tone of the article came off to me as a little detached. I don't think the article was trying to paint any particular doctor or group of doctors in a negative light but was just showing that the some of the procedures we routinely do need better evidence, which may or may not be true. The whole article felt very high brow and occasionally esoteric terminology and situations that I do not think will connect with the average American, it feels like its written for a particular type of thoughtful, statistics oriented individual, not your average casual reader.